| Ste Genevieve County Memorial Hospital | |
| 
					590 Pine Dr Ste Genevieve MO 63670-1456  | |
| (573) 883-4455 | |
| (573) 883-4472 | 
| Full Name | Ste Genevieve County Memorial Hospital | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 590 Pine Dr, Ste Genevieve, Missouri | 
| Authorized Official Name and Position | Amanda Wolk (BUSINESS OFFICE DIRECTOR) | 
| Authorized Official Contact | 5738837703 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ste Genevieve County Memorial Hospital Po Box 366 Ste Genevieve MO 63670-0366 Ph: (573) 883-4455  | Ste Genevieve County Memorial Hospital 590 Pine Dr Ste Genevieve MO 63670-1456 Ph: (573) 883-4455  | 
| NPI Number | 1730238551 | 
|---|---|
| Provider Enumeration Date | 01/10/2007 | 
| Last Update Date | 01/13/2023 | 
| Medicare PECOS PAC ID | 3274432802 | 
|---|---|
| Medicare Enrollment ID | O20040310001286 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1730238551 | NPI | - | NPPES | 
| 500142609 | Medicaid | MO | |
| CC8331 | Other | MO | RAILROAD MEDICARE | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Missouri) | Primary | 
| Provider Name | Kevin T Enger | 
|---|---|
| Provider Type | Practitioner - Urology | 
| Provider Identifiers | NPI Number: 1376607564 PECOS PAC ID: 3971401688 Enrollment ID: I20031219000342  | 
| Provider Name | Dan H Frissell | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1407829849 PECOS PAC ID: 8022093780 Enrollment ID: I20040618000828  | 
| Provider Name | Justin W Roberts | 
|---|---|
| Provider Type | Practitioner - Otolaryngology | 
| Provider Identifiers | NPI Number: 1619057064 PECOS PAC ID: 9436101524 Enrollment ID: I20050217000090  | 
| Provider Name | Matthew S Bosner | 
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) | 
| Provider Identifiers | NPI Number: 1922088749 PECOS PAC ID: 8325082225 Enrollment ID: I20050613000213  | 
| Provider Name | Gail L Craft | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1043361264 PECOS PAC ID: 0749217032 Enrollment ID: I20050719000339  | 
| Provider Name | Holly A Huelskamp | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1336229202 PECOS PAC ID: 7911922216 Enrollment ID: I20051005001202  | 
| Provider Name | Chandra B Dommaraju | 
|---|---|
| Provider Type | Practitioner - Infectious Disease | 
| Provider Identifiers | NPI Number: 1255361135 PECOS PAC ID: 7315963741 Enrollment ID: I20051017000191  | 
| Provider Name | Susan M Odonnell | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1720051162 PECOS PAC ID: 3678675170 Enrollment ID: I20070302000014  | 
| Provider Name | Casey L Stahlheber | 
|---|---|
| Provider Type | Practitioner - Pulmonary Disease | 
| Provider Identifiers | NPI Number: 1497950265 PECOS PAC ID: 4486754900 Enrollment ID: I20070713000117  | 
| Provider Name | Joann Uding | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1518089564 PECOS PAC ID: 6002974979 Enrollment ID: I20081021000631  | 
| Provider Name | Briccio S Cadiz | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1932182722 PECOS PAC ID: 2264598648 Enrollment ID: I20090310000449  | 
| Provider Name | Mary E Crecelius | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1841272861 PECOS PAC ID: 6406036508 Enrollment ID: I20110207000742  | 
| Provider Name | Kelly A Donze | 
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) | 
| Provider Identifiers | NPI Number: 1154636579 PECOS PAC ID: 4587833165 Enrollment ID: I20110816000838  | 
| Provider Name | Naeem Aslam | 
|---|---|
| Provider Type | Practitioner - Gastroenterology | 
| Provider Identifiers | NPI Number: 1750347902 PECOS PAC ID: 6002720349 Enrollment ID: I20120524000123  | 
| Provider Name | Kimberly L Browne | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1710239496 PECOS PAC ID: 7618120684 Enrollment ID: I20121227000369  | 
| Provider Name | Robin D Goff | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1639507957 PECOS PAC ID: 5597993105 Enrollment ID: I20140106000036  | 
| Provider Name | Lacey E Sullivan | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1174951503 PECOS PAC ID: 5395973697 Enrollment ID: I20140113001307  | 
| Provider Name | Regine E Politte | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1063813046 PECOS PAC ID: 2466673223 Enrollment ID: I20141020001092  | 
| Provider Name | Anne K Wolk | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1639562028 PECOS PAC ID: 8820318785 Enrollment ID: I20150518001731  | 
| Provider Name | Heather Jo Cheaney | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1225487143 PECOS PAC ID: 0143512590 Enrollment ID: I20160706000877  | 
| Provider Name | Melissa A Naeger | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1538616362 PECOS PAC ID: 0042590424 Enrollment ID: I20161130001108  | 
| Provider Name | Zaki H Chowdhury | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1366456022 PECOS PAC ID: 1456345669 Enrollment ID: I20161216000111  | 
| Provider Name | Christina Marie Peters | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1851767149 PECOS PAC ID: 5294042925 Enrollment ID: I20170815002537  | 
| Provider Name | Lisa Engle | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1437668969 PECOS PAC ID: 2567738081 Enrollment ID: I20171026003395  | 
| Provider Name | Erika Leung | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1326453721 PECOS PAC ID: 0345542106 Enrollment ID: I20180710003037  | 
| Provider Name | Samuel Mearl Medaris | 
|---|---|
| Provider Type | Practitioner - Otolaryngology | 
| Provider Identifiers | NPI Number: 1720159346 PECOS PAC ID: 5092861435 Enrollment ID: I20200123002871  | 
| Provider Name | Kelly R Grein | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1407455421 PECOS PAC ID: 2860803467 Enrollment ID: I20201203001991  | 
| Provider Name | Morgan Ritter | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1316529951 PECOS PAC ID: 7517362320 Enrollment ID: I20210817002353  | 
| Provider Name | Deniane John | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1881256014 PECOS PAC ID: 4981933439 Enrollment ID: I20220929000876  | 
| Provider Name | Stephanie R Moll | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1588374698 PECOS PAC ID: 1658744313 Enrollment ID: I20230227002949  | 
| Provider Name | Abigail Fischer | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1861146557 PECOS PAC ID: 1052772563 Enrollment ID: I20230801000749  | 
| Provider Name | Sarah Mariah Peth Bohnert | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1245857036 PECOS PAC ID: 0446673503 Enrollment ID: I20230913002899  | 
Ste Genevieve County Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 Plaza Dr, Ste Genevieve, MO 63670 Phone: 573-883-1199 Fax: 573-883-1189  | |
Ste Genevieve County Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Ste Genevieve Dr, Ste Genevieve, MO 63670 Phone: 573-883-4473 Fax: 573-883-4472  | |
Ste Genevieve County Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 753 Pointe Basse Dr, Ste Genevieve, MO 63670 Phone: 573-883-2782 Fax: 573-883-3681  | |
Ste Genevieve County Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 753 Pointe Basse Dr, Ste Genevieve, MO 63670 Phone: 573-883-2782  |